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��,� � APPLICAT: �N FOR CONSTRUC . ION PERMIT <br /> �(� CITY OF EVERETT•BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION �BUILOING ❑ MECHhNICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS: (011� tfiH D/L�vE .tE eUfk�urf WA �t�g p���Oin16 �l <br />� /'1�ueRooK A�rnc�A�€� ��� lo�a� ?nr Av£, se. �_vEAr-,-r R$ao8 3y7-Ybs7 <br /> �OYMEN �ILA ESOOTI 5—� CITY ZIP PI�ONE <br /> Nor�E <br /> TENANT MMUDDf1f.55" f.I1Y IIP PIIONE <br /> 2ick ANe«a_corJ IINI A � AVEnIu� GnMn�lnC wa qao�o ao� - ��8-2085 <br /> ARLNRECT OR OESIGNER 1A111�DORE55 Cltt 7��' n��ONE I <br /> MIU,flRoo�Ajs��A�t, I.�� lolao - ve �F, �€ru,� 9AauB 347•4is7 MIU.RAL�sSPP , <br /> GENEMLCONTiUCTOR MeILAD011E55 Cirv 7�� ��IONE 5�41ElICENSE� �.. <br /> M�EN�ac�a�cTo-"R�M�°T°Ass (144� I�o'M N� �kiRkLANa UIFl 9Ph�� 266-So3 I,$68 RE^iAsMS�NSLF , <br /> R &�N o� P�uMIuA6 �c 607 SE EV61t6Tr M4{U- WAY �Ead �v�r qRaaa 35��-b171 Rog�Nfl�a�a�:� <br /> LUI.�BINGCONTR�CTOR MAILAOORE55 i:ITY ZIP PIIONE STAIEUCENSE� i <br /> GONiMCTPRICEOFWpf1N HEATING SYSTEM: I�GAS ❑ ELECTflIC ❑ II' <br /> � IO 0 . — <br /> DESCRIBE WOi1K ANO$OU�PE FOOT�GE INVOLVEb GONi�CT PFRSUN AN�PNONE NO <br /> u� u �a � ti � R� �n 3H� - �r6.- <br /> ad9� � ��s � � s <br /> I HEREBY CERTIFY THAT 1 HAVE READ AN� EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COFflECT ALL <br /> P{IpPOSEUlISE OF BUILD�N`p! PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> f�FSIO�P�!� WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR . <br /> LEGALDESCRIPTfOVOFPPOPE11ttI51NW-•BEIOW c��nvoconies NOT. THE GRANTING OF A PERMIT DOES NOT PPESUME TO GIVE <br /> ipi _e�ocK___oF AUTFIORITY TO VIOLATE OF CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUC710N OR THE <br /> _ s�E �T.�- �j� PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> -�''r OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLI ATION IS MADE AND I MPLY WITH THE STATE <br /> PAHCELTA%I.D.MUMBER CO A ORS LAW 1827 RCW AND 6.200 WAC. <br /> 3970- voe- oig- oaog ('/ ,-. <br /> CONSTRUGTION LOAN LFWDER,AOURE55.TEIEPNONE NUMPER � -1� (�- �� <br /> I�S BAt�k — �rtNet Ro'�{ 'aa6 •454- S S � ru"E o"'E <br /> -, <br /> IO 00 g SSO (��J,�,�1/UE 00 CITYBUSINESSUCENSENO <br /> PLUMBING MECIfANICAL <br /> NO. TYPE OF FDITURE OR ITEM FEE NO. 7YPE OP EUUIPMI'NT FEE <br /> WATEH CLOSET(TOILET) � �-�' A/C--AlHNDLG UNRS ' <br /> BATHTUB ; FORCED AIR SYSTEMS i <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER ' UNIT HEATERS ' <br /> KITCHEN SINK 8 DISP � CLOTHES ORVERS � <br /> DISHWASHER '07 RANGE HOOD ' <br /> LAUNDRYTRAY ; WATER HEATER �_ <br /> CLOTHES WASHER � WOODSTOVE ' <br /> .Q- URINAL ' MEfAL FIREPIACE(WOOD BURN�NG) ' <br /> DHINKING FOUNTAIN i -{�1 FIREPLACE INSERT(WOOD BURNING) i <br /> FLOOR DRAIN <br /> � GAS FIREPLACE ' <br /> BACKFtOW PREVENTERS � -$- GASRANGE � <br /> � SINK(SERVICE-BAR,ETC.) � GAS PIPING ' <br /> � EXHAUSTFAN � <br /> � ` <br /> � ' <br /> � ' <br /> - � � <br /> SUB TOTAL E ; SUB TOTAL E ; <br /> PERMIT S � __ PERMIY 5 (� � <br /> TOTALFEE E ' TOTALFEE E ' <br /> FOR OFFICE USE ONLY: <br /> pppNTSETBACK pEAf15F.TBRCR SIDESETBACe �UNCIIECNNuue f[f- fifCfIPTNO <br /> 5a�'aa– 30 <br /> useza+e �or•aen ��C�N151LE FEES VAWATION FE T_ <br /> 7 i � <br /> ❑YES O NO pUILDING y(Jr � <br /> IIEIG111 UMIT�TION NO OF OWEILING SRE 0�OIDG�TI �h 1 <br /> UNII$ �[ 62 S,F. Uv�u4 �{- ru�uowc <br /> 2 SF G4kAw '�'-�--- <br /> OCCUPANCY NO Oi 90FIE5 OCCUPANI LOsO BASEMENI A�FCnnNICAL _ 17� :_. <br /> cnouv - , " <br /> a a �-i 2 oYEs �� ; <br /> - nno�rior+ni.ruu u�[cK <br /> FINE SPPINNIER REO'0 �EASON �— <br /> on�en <br /> RPENMMREO'D �Es50N ii— <br /> STNEUVIlO�Nf.511f1C1UpGE — �� <br /> trvEovr,ONST rtnNS�rrnovEner CITYOFEVERETT runnr.wonKS 1 <br /> J�� LOGALSALES — ------ i_J— <br /> -� o.te � 3 (p TAX CODE IS �105 7o7AL _ - <br />